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Monday, July 27, 2009

Deadline for worthwhile work: age 40?

Take the sum of human achievement in action, in science, in art, in literature—subtract the work of the men above forty, and while we should miss great treasures, even priceless treasures, we would practically be where we are today . . . The effective, moving, vitalizing work of the world is done between the ages of twenty-five and forty.

I came across this quote by renowned Canadian physician William Osler a few months ago and found it disconcerting. Not because I disagree with it, but because I wonder if there might be truth in it. And because I am a thirty-five year-old mother of three who has been treading water career-wise, working two days a week, with plans to truly launch myself professionally in another five years or so.

Then I watchedIn the Shadow of the Moon last week, Ron Howard's documentary on the moon landings, and was struck by the fact that Neil Armstrong, Buzz Aldrin and Mike Collins were all 38 when they flew to the moon in 1969. Arguably at the pinnacle of their careers, they were three years older than I am.

So I find myself wondering - have I already peaked? Have the opportunities for my best professional work slipped by while I've been laundering onesies and making homemade chicken stock? Or have they simply been postponed, with the next decade being my professional hurrah, as hoped?

My twenties were characterized by energy and optimism. My thirties have seen an indisputable downturn in both, but gains in insight and creativity. I thought perhaps each decade would burnish some new qualities, culminating at age . . . fifty-five? sixty? I don't really think that far ahead. But I was certainly counting on having more than the next five years to make my mark.

So - if you are at the end of your career, at what age did you make your greatest contributions? If you have passed forty, do you feel that your most productive years are behind you? And if you aren't yet forty, what years do you expect will be your best?

With all due respect, I think Sir William is full of crap. My observations are that unless you're in a career where very good physical health is a necessity (astronaut, athlete), you peak between 50 and 60, and for many people in medicine and academics, that peak is a plateau that continues well into your sixties.

Objectively, it's hard to disagree with Osler, BUT of course we have to remember you were a practicing physician much younger in his day... you didn't have the standard 4 years undergrad + 4 years med school + 3-4 years residency before you could really practice. So you have to adjust the timetable for that, and of course in 1905 there weren't very many women doing much of anything career-wise, so there was no need to adjust for child-bearing and rearing during that 25-40 "prime". Taken in sum, I think it's safe to say that for some pretty good reasons we've got a later peak :) At least I hope so!

Osler had his moments, but he was a creature of his sex, class and era - and arrogant about it, too.

I'm 49 (a week ago) and just starting what I believe will be my most meaningful work. I don't think that's just true for women, either; my husband is still moving toward his professional peak and he's the same age I am.

I agree with the above commenter that with the long training process in medicine, it would be impossible to peak so early in life.

However, I think there's a difference between coming up with an amazing discovery and simply being good at what you do. When we're young, our brains are more plastic and we're more able to come up with crazy discoveries like electricity. But when it comes to quality and creating polished work, older is better (to a point, of course). Clearly, when you want quality, like good health care, someone in their 50s is likely way superior to someone in their 30s. I think we'd all agree on that.

In summary, if you want to come up with a world-changing discovery, your time may be running short. But it's not too late to be a great doctor :)

Did you know that the average life expectancy in 1905 was 47? If you die at about 47, odds are, you're slowing down and sickly in the years before hand. If we equate that to today- the average life expectancy is between 75 and 80. I agree that most people don't make life long achievements at 70 or 75. That still gives us the years between 40 and 70 to do something fabulous!

@Fordo: Yes, I saw similar figures but it depends on how you look at it. The life expectancy in the early 1900's in America for 40-year-olds was 27 years - ie If you made it to 40, you'd likely live on into your late 60's.

I think Fizzy's take is closest to what Osler was getting at: good work is possible past forty but brilliant discoveries etc. become less likely.

I just want to say, FreshMD, that even though you might not feel like you've given your greatest contribution career-wise, I am really inspired by your job providing primary care to immigrants. Just want to know there is one medical student who really look up to your work, even if you are working less in order to make your family a high priority as well.

To FreshMD: you're nowhere near a deadline in worrying about a satisfying career that contributes to society. I agree that many brilliant discoveries are made early in life, but let's face it. Most of us in Medicine, even those in research, will not be on the Nobel Prize roster. We want to care for the sick, improve lives of others, teach new students and residents, and enjoy the day to day challenge of problem solving. There's no deadline on that. I left academic/employed hospital status at age 60, not to retire, but to start an independent private practice. It's been a fantastically satisfying adventure, with a work schedule busier than before. New skills had to be acquired to "run a business", and the change is what keeps a career interesting.

Well, dang! I think I'm very productive in my 50's. A whole lot more so now that the children are raised and menopause is over thankyouverymuch. Sure, I'm not gonna discover the cure for cancer but by 50 you pretty well get over that idea anyway. Course, you gotta remember as stated above: when Osler was around people generally croaked by fifty to sixty.

Gosh, I really appreciated Forbo's comment, which gives me another 29 years to peak professionally! I passed 40 some time back, but with small kids in the house for the past 9 years, reaching my professional potential has hardly been the focus at our house. I suspect the 50s are going to be VERY good, possibly even particularly productive, years.

After 19 years of a fairly routine job in nursing education while raising us, my mother went to graduate school at the age of 42. After graduation she found a job as a nursing professor, went back for her PhD, started and runs a Masters in Nursing program as well as several certification programs at the University where she teaches and has been a key part of research, both local and international. She is currently in her sixties. She now enjoys travelling the world(something she never got to do when we were younger) for various conferences.

Mothers in Medicine is a group blog by physician-mothers, writing about the unique challenges and joys of tending to two distinct patient populations, both of whom can be quite demanding. We are on call every. single. day.

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